Do we need more than one Child Perceptions Questionnaire for children and adolescents?

Background: In dentistry, measures of oral health-related quality of life (OHRQoL) provide essential information for assessing treatment needs, making clinical decisions and evaluating interventions, services and programmes. The two most common measures used to examine child OHRQoL today are the Child Perceptions Questionnaire at two ages, 8-10 and 11-14 (CPQ(8-10), CPQ(11-14)). The reliability and validity of these two versions have been demonstrated together with that (more recently) of the short-form 16-item impact version of the CPQ(11-14). This study set out to examine the reliability and validity of the Child Oral Health Quality of Life Questionnaires (COHQOL) instruments the CPQ(8-10) and impact short-form CPQ(11-14) in 5-to-8-year-old New Zealand children, and to determine whether a single measure for children aged 5-14 is feasible. Method: A cross-sectional survey was conducted of 5-to-8-year-old children attending for dental treatment in community clinics in 2011. Children were examined for dental caries, with OHRQoL measured using the CPQ(8-10) and short-form CPQ(11-14). Construct validity was evaluated by comparing mean scale scores across ordinal categories of caries experience; correlational construct validity was assessed by comparing mean CPQ scores across children's global ratings of oral health and well-being. Results: The 183 children (49.7% female) aged 5 to 8 years who took part in the study represent a 98.4% participation rate. The overall mean dmft was 6.0 (SD, 2.0 range 1 to 13). Both questionnaire versions detected differences in the impact of dental caries on quality of life, with the greatest scores in the expected direction. Both versions showed higher scores among those with poorer oral health. There was a very strong and positive correlation between CPQ(11-14) scores and CPQ(8-10) scores (Pearsons's r = 0.98; P < 0.01). Conclusion: The performance of both versions of the COHQOL measures (CPQ(8-10) and short-form CPQ(11-14)) appears to be acceptable in this younger age group, and this work represents the first stage in validating this questionnaire in a younger age group. It also further confirms that younger children are capable of providing their own perceptions of oral health impacts. The acceptability of the short-from CPQ(11-14) in this younger age group lends support to its use in children between ages 5 and 14.